Detection of minimal residual disease in acute and chronic leukemias

Current Opinion in Hematology

Volumn 3, Issue 4, 1996, Pages 310-314

  Radich, Jerald ^a  

^a Fred Hutchinson Cancer Research Center   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACUTE LEUKEMIA; ACUTE LYMPHOBLASTIC LEUKEMIA; CANCER DIAGNOSIS; CANCER RECURRENCE; CHRONIC GRANULOCYTIC LEUKEMIA; CHRONIC LEUKEMIA; CHRONIC MYELOID LEUKEMIA; DISEASE SEVERITY; DNA FINGERPRINTING; HUMAN; MINIMAL RESIDUAL DISEASE; POLYMERASE CHAIN REACTION; PRIORITY JOURNAL; REMISSION; REVIEW;

EID: 0030055639     PISSN: 10656251     EISSN: None     Source Type: Journal    
DOI: 10.1097/00062752-199603040-00010     Document Type: Review

References (21)

1. Radich J, Gehly G, Gooley T, Bryant E, Clift RA, Collins S, Edmands S, •• Kirk J, Lee A, Kessler P, Schoch G, Buckner CD, Sullivan KM, Appelbaum FR, Thomas ED: PCR detection of the bcr-abl fusion transcript after allogeneic marrow transplantation for chronic myeloid leukemia: results and implications in 346 patients. Blood 1995, 85:2632-2638. The largest study to date demonstrated that PCR positivity is highly associated with the risk of relapse even after controlling for other clinical variables associated with relapse such as phase of disease and GVHD status. PCR positivity at 6 to 12 months after BMT was associated with a 42% risk of relapse at a median of 200 days from the first PCR-positive result, as opposed to a 3% risk in PCR-negative patients. This study also documents the lower risk of relapse associated with PCR positivity in unrelated donor transplants.
2. Pichert G, Roy DC, Goin R, Alyea EP, Belanger R, Gyger M, Pereault C, • Bonny Y, Lerra I, Murray C, Soiffer RJ, Rits J: Distinct patterns of minimal residual disease associated with graft-versus-host disease after allogeneic bone marrow transplantation for chronic myelogenous leukemia. J Clin Oncol 1995, 13:1704-1713. The authors studied 48 T-cell-depleted and 44 untreated marrow transplant patients and found that PCR positivity is asssociated with relapse; 100% of persistently PCR-positive patients, 30% of intermittent positive patients, and 0% of persistently negative patients relapsed. Unfortunately, the relapse risk was not stratified by the type of transplant. T-cell-depleted transplants were, however, much more likely to be PCR-positive.
3. Gaiger A, Henn T, North E, Geissler K, Mitterbauer G, Maier-Dobersberger •• T, Greinix H, Mannhalter C, Haas OA, Lechner K, Lion T: Increase of BCR-ABL chimeric mRNA expression in tumor cells of patients with chronic myeloid leukemia precedes disease progression. Blood 1995, 86:2371-2378. The authors show that an increase (at least 10-fold) in bcr-abl message proceeds progression from chronic to advanced stage in 11 patients. In the 14 patients who remained in chronic phase, the bcr-abl level remained relatively stable.
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6. - and population. In addition, in several patients fluorescence in situ hybridization detected the aberrant cells in lymphoid lineages.
7. - cells.
8. +). Leukemia 1995, 9:450-457.
9. - population.
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11. Tobal K, Suanders MJ, Grey MR, Yin JAL: Persistence of RAR alpha-PML • fusion mRNA detected by reverse transcriptase polymerase chain reaction in patients in long-term remission of acute promyelocytic leukaemia. Br J Haematol 1995, 90:615-618. Eighteen patients were studied in remission. None were positive for PML-RARα, but surprisingly six tested persistently positive for the reciprocal RARα-PML chimeric mRNA.
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15. Liu PP, Hajra A, Wijmenga C, Collins FS: Molecular pathogenesis of the •• chromosome 16 inversion in the M4Eo subtype of acute myeloid leukemia. Blood 1995, 85:2289-2302. An excellent review.
16. Tobal K, Johanson PRE, Saunders MJ, Harrison CJ, Yin JAL: Detection of • CBFB/MYH11 transcripts in patients with inversion and other abnormalities of chromosome 16 at presentation and remission. Br J Haematol 1995, 91:104-108. Four patients were studied in remission and all four were positive for CBFB-MYH11 from 1 to 108 months after therapy, including a single patient 22 months after allogeneic BMT.
17. Steenbergen EJ, Vertragen OJHM, Vanleeuwen EF, Vandenberg H, • Vondembome AEGK, Vanderschoot CE: Frequent ongoing T-cell receptor rearrangements in childhood B-precursor acute lymphoblastic leukemia: implications for monitoring minimal residual disease. Blood 1995, 86:692-702. T-delta oligoclonality at diagnosis appears more common than previously believed. In 30 patients with V-δ2-γ3 rearrangments, 23 showed subclones with further rearrangement to V2D2Jα. TCR-δ rearrangments were unstable from initial diagnosis to first relapse in seven of eight patients but remained constant therafter.
18. Baruchel A, Cayuela JM, Macintyre E, Berger R, Sigaux F: Assessment of • clonal evolution at Ig/TCR loci in acute lymphoblastic leukaemia by single-strand conformation polymorphism studies and highly resolutive PCR derived methods: implication for a general strategy of minimal residual disease detection. Br J Haematol 1995, 90:85-93. Twelve patients with T-cell ALL and 14 with B-cell ALL were studied at presentation and diagnosis; two of 12 patients with T-cell ALL and five of 14 patients with B-cell ALL showed clonal rearrangements that could lead to false-negative minimal residual disease assays if only one target was utilized.
19. Ghali DW, Panzer S, Fischer S, Argyrioutirita A, Haas OA, Kovar H, • Gadner H, Panzergrumayer ER: Heterogeneity of the T-cell receptor delta gene indicating subclone formation in acute precursor B-cell leukemias. Blood 1995, 85:2795-2801. Four patients had a coexistence of different junctional genes with the same VD or DD rearrangement.
20. Seriu T, Yokota S, Nakao M, Misawa S, Takaue Y, Kozumi S, Kawai S, • Fujimoto T: Prospective monitoring of minimal disease during the course of chemotherapy in patients with acute lymphoblastic leukemia, and detection of contaminating tumor cells in peripheral blood stem cells for auto-transplantation. Leukemia 1995, 9:615-623. Three of 14 patients who tested PCR positive relapsed compared with one of 17 PCR-negative cells. Five patients who tested PCR positive during remission did not relapse. Peripheral blood stem cells tested PCR positive in four of five patients, all of whom tested PCR positive before collection; three of four relapsed.
21. Radich J, Ladne P, Gooley T: Polymerase chain reaction-based detec• tion of minimal residual disease in acute lymphoblastic leukemia predicts relapse after allogeneic BMT. Biol Blood Marrow Transplant 1995, 1:24-31. Twenty patients were studied after allogeneic BMT; 13 patients had at least one PCR-positive assay in the first 100 days after transplantation and 11 relapsed. The relative risk of relapse associated with a PCR-positive assay was 6.4.